Surgery is a common step taken by the medical team to handle the blockage case in the colon, or also known as Hischsprung disease (congenital megacolon). Nevertheless, published doctors’ reports showing that this step is quite risky with the failure rate due to inflammation of the bowel, complications, constipation and mortality is quite high. However, now people do not need to feel anxious or worried because a new surgical technique to minimize the complications has been developed by Dr.dr. Rochadi, Sp.B., Sp.BA., (K), lecturer of UGM Faculty of Medicine.
Megacolon disease is an inherited disorder that often occurs in Indonesia with the incident one in 5,000 births. It is estimated that 1,200 new cases will occur each year. The disorder occurs due to the narrowing of the patient’s intestinal tract resulting in defecating difficulty.
Rochadi described surgery in patients with megacolon is usually done by opening the abdominal wall, make a hole in the stomach, and cut the colon in supine position. But with the new technique, namely the Posterior Sagittal Neuroctomy Repair for Hischsprung Disease (PSNRHD) method, the surgery is only performed once with direct operations in areas of narrowing through intergluteal slices with the patient in face down position.
"This technique is a simple surgical technique, just one stage of operation, more quickly, using minimal equipment. Hopefully, this technique can be applied at the district hospital because mostly surgery for the disease is done only at type A hospital," he said after defending his dissertation entitled “Surgical Therapies and the Role of Gena Ret In Hischsprung Disease in an open Doctoral Program Examination, Thursday (23/2).
Rochadi revealed that surgery with the new surgical technique only takes about 30 minutes, much shorter than general surgery which takes about 2.5 -3 hours. In addition, the surgical technique is able to minimize the risk of intestinal inflammation, complications, constipation and death.
Rochadi’s research that was conducted in January 2005 on 104 patients with megacolon disease with age ranging between1 month to 9 years old showed that the risk of intestinal inflammation, complications, constipation, and death is quite low. Through the new operating techniques the occurrence of constipation appears as many as 7 cases (11.95), whereas with the old operation technique it is as many as 19 cases (42.2%). Furthermore, the occurrence of injury or inflammation of the intestines (enterocolitis) with a new technique appears only 4 cases (6.8%), whereas with the older operating techniques appears 14 cases (31.1%). "High occurrence of complications was also seen at the old operating techniques surgery, namely 16 cases (35.6%) while using the new operating technique, only 6 cases of patients experienced complications," explained the pediatric surgery specialist of Dr. Sardjito Hospital.
Rochadi added that through this new surgical technique the patient’s quality of life is also better. Mortality in patients with megacolon usually occurs due to post-operative enterocolitis and constipation after surgery.
Megacolon disease treatment can also be done manually. "To overcome the blockage of the colon, in patients who did not want to be operated, health workers in the region usually treat the disease using a banana or bamboo inserted into the anus. This method actually has risk of injuring the anal canal", he explained.
Seeing these conditions the man born in Pleret, Bantul, 5 April 1950 encouraged to develop a new tool named "Gama Sardjito" which has been used since 2005. The tool is made of stainless steel metal with lengths ranging from 15-20 cm with 7-14 mm of diameter for children and of 15-20 mm for adults. The working principle of this tool is to widen or relax the anal canal of megacolon patients.
"The healing process is not fast, it should be done for at least 3 months of therapy," he explained.
The tools created by Rochadi can be obtained at a modest cost. A set of this tool is expected to be sold at a price not exceeding Rp100,000 while in the market these tools are usually sold for Rp500,000.
"Currently, the patent is being applied for," he concluded.